The cocaine connection: users imperil their gingiva

Article Abstract:

Application of cocaine to the gums (gingiva) is a novel method of using the substance, and it leads to gingival ulcerations and tissue damage. Cocaine, now the most commonly used intravenous drug, may also be sniffed; in such cases, it can cause tissue damage in the nasal septum (located between the nostrils). If smoked, cocaine can result in rupture of the airway. The drug has potent vasoconstrictive properties (causing blood vessel constriction) that are largely responsible for such dangerous effects. The observation that AIDS patients who applied cocaine to their gums developed gum destruction led to a larger study of periodontal health among 181 AIDS patients. During a one-year period, patients were questioned regarding cocaine use, and their oral health was evaluated. Results showed that nine patients (5 percent) had signs of destruction of soft (gum) tissue and hard periodontal tissue (the bone in which the teeth are inserted) after several weeks of cocaine application to the gum areas. When the patients stopped such usage, their lesions healed within a few months. The oral mucosa have been exposed to cocaine in societies where the coca leaf is chewed, but without damaging effects on the gums. The development of mouth ulcers after cocaine application in AIDS patients may be a consequence of the rubbing action. Whether such changes occur among cocaine users who are not AIDS patients is unknown. In any event, AIDS patients should be questioned regarding possible application of cocaine if they develop mouth ulcers of a certain type. (Consumer Summary produced by Reliance Medical Information, Inc.)

Author: Klein, Robert S., Small, Catherine Butkus, Quart, Arthur M.
Health aspects, Physiological aspects, AIDS patients, Drug use, Cocaine, Gums, Gingiva

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Nail dyschromia associated with zidovudine

Article Abstract:

The drug zidovudine is used to treat acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC), and has been associated with the development of skin reactions. Zidovudine has been shown to cause nail dyschromia, or discoloration of the nail, particularly in dark-skinned patients. Various drugs such as anti-cancer, antimalarial, and cytotoxic or cell-killing agents, as well as certain conditions, such as pregnancy, Addison disease, and radiotherapy are also capable of causing nail discoloration. Zidovudine-related nail dyschromia is characterized by widespread areas of increased coloration that may run either lengthwise or crosswise on the nail, and it occurs more commonly among black patients. The mechanism of zidovudine-related nail discoloration was not elucidated in this study, but it may be related to an effect of zidovudine on the growth of melanocytes, cells that produce melanin, the pigment that gives color to hair, skin, and portions of the brain and eye. Both physicians and patients should be aware of the ability of zidovudine to cause nail dyschromia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Author: Klein, Natalie C., Don, Philip C., Fusco, Francesca, Fried, Philip, Batterman, Amy, Duncanson, Frederick P., Lenox, Theodore H.
Complications and side effects, Drug therapy, AIDS (Disease), Zidovudine, Nails (Anatomy)

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